Blade Free LASIK (a.k.a No Blade LASIK) is lasik done with a combination of a femtosecond laser and an excimer laser.

When LASIK first started, the lasik flap was created by a mechanical microkeratome, followed by corneal reshaping with an excimer laser. The mechanical microkeratome is a complex and delicate mechanical instrument, which incorporates an oscillating blade to create the LASIK flap. While LASIK is a very safe procedure, most of the problems during LASIK (or post-LASIK) related to the use of the mechanical microkeratome. These problems were partly because of mechanical problems during the flap creation process. It was also partly because of the lack of precision associated with a rather difficult mechanical instrument.

Blade Free LASIK uses a femtosecond laser to fire millions of extremely tiny pulses of laser light, in a horizontal plane on the cornea. Each pulse of the laser light converts a tiny amount of corneal tissue into gas. When millions of pulses are laid down, the cornea gets seperated along a plane. When properly directed, this can be used to create a LASIK flap, which can then be lifted to one side, just like a conventional lasik flap.

Blade Free LASIK was first introduced in the beginning of the current century by a company called Intralase (the company is now part of a large ophthalmic company called AMO). Initially, the Intralase used very high energy and a low pulse frequency. This often lead to a lot of inflammation in the eye, and other side effects. Today, the Intralase (the current model is called iFS) is a more accomplished machine, which allows relatively effortless flap making. In the meantime, other companies like Zeimer (Femto-LDV,Swiss), Carl Zeiss Meditec (VisuMax, German), and Technolas 20/10 Perfect Vision (Femtec, German) have introduced faster machines, which use even lower energy and higher frequency than the Intralase. In our personal knowledge, the iFS, Femto-LDV, and VisuMax machines all create nice flaps, with a much higher degree of precision and safety than previous generations of femtosecond lasers, and the current generations of mechanical microkeratomes.

On the flip side, femtosecond lasers are costly, and there are license fees associated with every use of the laser. This makes Blade Free LASIK much costlier than LASIK done with a mechanical microkeratome.

See later posts for advantages of the femtosecond laser.